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Technology Meets Tradition: CO2 Laser Circumcision versus Conventional Surgical Technique

Authors Ronchi P, Manno S, Dell'Atti L

Received 7 May 2020

Accepted for publication 24 June 2020

Published 16 July 2020 Volume 2020:12 Pages 255—260


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Jan Colli

Piero Ronchi,1 Stefano Manno,2 Lucio Dell’Atti1

1Department of Urology, University Hospital “Ospedali Riuniti”, Ancona, Italy; 2Urology Unit, Hospital “Pugliese Ciaccio”, Catanzaro, Italy

Correspondence: Lucio Dell’Atti
Department of Urology, University Hospital “Ospedali Riuniti”, 71 Conca Street, Ancona 60126, Italy
Tel +39 071 5966523
Fax +39 071 5963367

Purpose: We wished to present the clinical applications and to evaluate the benefits of the use of a carbon dioxide (CO2) laser versus the conventional procedure for circumcision in adults, in terms of duration of surgery, surgical techniques, complications, pain and cosmetic appearance.
Patients and Methods: The medical records of 482 patients who had been circumcised were retrospectively evaluated. The patients were divided into two groups: 168 patients (Group A) were circumcised with traditional techniques; and 314 patients (Group B) were circumcised using a CO2 laser. All the patients were circumcised under local anesthesia. Pain was evaluated using a verbal numerical rating scale for pain assessment. Postoperative wound swelling, bleeding, infection and pain were assessed at 4 hours, 24 hours and 7 days after surgery.
Results: There were no significant differences between the two groups in terms of bleeding and infections. The difference in operating times between the groups was significant (p< 0.001). Wound disruptions occurred in one patient in Group A at 3 days and two patients in Group B at 1 week. Pain scores were low and there was less pain in Group B than in Group A during the first 4 hours (1.8 vs 3.7; p< 0.002). Compared with the conventional method, the CO2 laser technique was associated with much less pain at both 1 day (p< 0.002) and 7 days (p< 0.001) postoperatively. The cosmetic results were superior in Group B; a linear surgical scar developed in 94.9% of patients in Group B versus 61.3% in Group A (p< 0.001).
Conclusion: Our results show that the use of a CO2 laser was associated with a shorter operative time, less wound irritation and better cosmetic appearance compared with standard surgical techniques for circumcision.

Keywords: CO2 laser, circumcision, surgical technique, outcomes

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